Pregnancy and newborn health - heat impacts and emerging solutions.

Evidence is accumulating, both in the US and abroad, of the apparent serious health impacts of various environmental exposures tied to climate change. High ambient temperature, or heat, is a worsening global health risk. Heat risk is affected by many factors such as the magnitude, duration, and timing of exposure - such as specific, critical windows during pregnancy.

Climate change, women's health, and the role of obstetricians and gynecologists in leadership.

Climate change is one of the major global health threats to the world's population. It is brought on by global warming due in large part to increasing levels of greenhouse gases resulting from human activity, including burning fossil fuels (carbon dioxide), animal husbandry (methane from manure), industry emissions (ozone, nitrogen oxides, sulfur dioxide), vehicle/factory exhaust, and chlorofluorocarbon aerosols that trap extra heat in the earth's atmosphere. Resulting extremes of weather give rise to wildfires, air pollution, changes in ecology, and floods.

The Effectiveness of Narrative Versus Didactic Information Formats on Pregnant Women's Knowledge, Risk Perception, Self-Efficacy, and Information Seeking Related to Climate Change Health Risks.

Climate change is a global threat that poses significant risks to pregnant women and to their developing fetus and newborn. Educating pregnant women about the risks to their pregnancy may improve maternal and child health outcomes. Prior research suggests that presenting health information in narrative format can be more effective than a didactic format.

Telehealth in Maternity Care.

The use of telehealth is gaining momentum in providing obstetric care. Telehealth through various platforms provides obstetricians and gynecologists and other providers of obstetric and postpartum care with the tools to better facilitate prenatal, intrapartum, and postpartum encounters. Telehealth helps facilitate consultation with specialists and subspecialists in maternal-fetal medicine in a team-based fashion to improve quality and safe obstetric practices in a fragmented obstetric care delivery system, especially in rural access communities.

Association of Air Pollution and Heat Exposure With Preterm Birth, Low Birth Weight, and Stillbirth in the US: A Systematic Review.

Importance: Knowledge of whether serious adverse pregnancy outcomes are associated with increasingly widespread effects of climate change in the US would be crucial for the obstetrical medical community and for women and families across the country.

Objective: To investigate prenatal exposure to fine particulate matter (PM2.5), ozone, and heat, and the association of these factors with preterm birth, low birth weight, and stillbirth.

Connected Health and Mobile Apps in Obstetrics and Gynecology.

Mobile apps and mobile health interventions have the potential to alter the landscape of medicine significantly, from how care is provided at the bedside to the ability to recruit patients and conduct medical research. Mobile apps have the potential to be used for prenatal care, postsurgical follow-ups, informing patients about conditions, and helping with the management of illness. They have the ability to remodel prenatal care and strive toward more personalized medicine.

Telehealth Interventions to Improve Obstetric and Gynecologic Health Outcomes: A Systematic Review.

Objective: To systematically review the effectiveness of telehealth interventions for improving obstetric and gynecologic health outcomes.

Data Sources: We conducted a comprehensive search for primary literature in ClinicalTrials.gov, Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, EMBASE, PubMed, and MEDLINE.

Environmental Exposures in Reproductive Health.

Our genetic makeup and environment interact. Evidence has emerged demonstrating preconception and prenatal exposure to toxic agents have a profound effect on reproductive health. We cannot change our genetics, but we can change our environment.

Project TENDR: Targeting Environmental Neuro-Developmental Risks The TENDR Consensus Statement.

Children in America today are at an unacceptably high risk of developing neurodevelopmental disorders that affect the brain and nervous system including autism, attention deficit hyperactivity disorder, intellectual disabilities, and other learning and behavioral disabilities. These are complex disorders with multiple causes—genetic, social, and environmental. The contribution of toxic chemicals to these disorders can be prevented.

International Federation of Gynecology and Obstetrics opinion on reproductive health impacts of exposure to toxic environmental chemicals.

Exposure to toxic environmental chemicals during pregnancy and breastfeeding is ubiquitous and is a threat to healthy human reproduction. There are tens of thousands of chemicals in global commerce, and even small exposures to toxic chemicals during pregnancy can trigger adverse health consequences. Exposure to toxic environmental chemicals and related health outcomes are inequitably distributed within and between countries; universally, the consequences of exposure are disproportionately borne by people with low incomes.

Back to the future: a history of ACOG in social media's golden age.

Purpose Of Review: To chronicle a medical professional society's adoption of innovation and to describe themes pertinent to the adoption.

Recent Findings: In September 2013, the American College of Obstetricians and Gynecologists (ACOG) published a Committee Opinion on Toxic Environmental Agents that included an infographic and social media awareness campaign. To date, it claims one of the highest total audience reaches for an ACOG Facebook post reaching nearly 18 000 viewers.

Combination antiretroviral therapy with protease inhibitors in HIV-infected pregnancy.

Objective: To evaluate the possible association between protease inhibitor (PI) and premature birth and low birth-weight in HIV-infected pregnancies.

Materials And Methods: Data were collected retrospectively for maternal and pregnancy characteristics, antiretroviral medication, lowest CD4 count and highest viral load during pregnancy, and pregnancy outcomes. χ(2) Analysis, Student's t-test, and multiple logistic regression analysis were performed.

Rapid HIV testing and obstetrical characteristics of women with unknown HIV serostatus at time of labor and delivery.

Objective: To describe the obstetrical characteristics of women without prenatal care and/or undocumented human immunodeficiency virus (HIV) serostatus who presented for delivery and to assess the usefulness of rapid HIV screening in these women.

Materials And Methods: The study design was a retrospective analysis. Demographics, labor, delivery characteristics, and pregnancy outcomes of women without prenatal care and/or unknown HIV serostatus were reviewed.

Preterm birth after mature fetal lung indices: is there any neonatal morbidity?

Objective: To determine the frequency of immediate morbidities in neonates with evidence of mature fetal lung indices who delivered before 37 weeks gestation.

Methods: A retrospective analysis was performed on pregnancies resulting in birth at < 37 weeks after mature fetal lung was documented by phosphatidylglycerol, lecithin/sphingomyelin ratio, or TDx-FLM studies. Pregnancies with multifetal gestations, maternal diabetes, or fetal anomalies were excluded.

Pyridoxine-related metabolite concentrations in normal and Down syndrome amniotic fluid.

Introduction: Some studies of children with Down syndrome have found mild abnormalities in the metabolism of pyridoxine (vitamin B(6)); therefore the present question is whether such abnormalities might also be present in the amniotic fluid of fetuses with Down syndrome.

Materials And Methods: Archived specimens of amniotic fluid were obtained from chromosomally normal and from fetuses with Down syndrome. Gas chromatography/mass spectrometry quantitized B-related metabolites, including oxalate, xanthurenate, kynurenine and 4-pyridoxic acid.

Organic acid concentrations in amniotic fluid found in normal and Down syndrome pregnancies.

Introduction: Organic acids were examined from normal and Down syndrome pregnancies to identify possible differences between the amniotic fluid from fetuses with Down Syndrome compared with that of normal fetuses.

Materials And Methods: Amniotic fluids were obtained from prior amniocenteses. Forty-one normal and 22 Down syndrome specimens were assayed using gas chromatography/mass spectrometry.